Endometrin as luteal phase support in assisted reproduction

Feinberg, Eve C.; Beltsos, Angeline; Nicolaou, Elitsa; Marut, Edward L.; Uhler, M.L.

doi:10.1016/j.fertnstert.2012.09.019

Cited by 24 publications

(20 citation statements)

References 16 publications

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“…In contrast, the most recent Cochrane review of randomized trials did not find any statistically significant differences in outcomes between intramuscular and vaginal P replacement for embryo transfer in cycles without ovarian stimulation (22); however, the review authors acknowledged a lack of sufficient power for adequate evaluation. Some retrospective comparisons of vaginal versus intramuscular P replacement for cryopreserved embryo transfers have shown significantly lower birth outcomes in cycles with the use of vaginal P alone (25,26,29), in agreement with the results of the present prospective randomized trial.…”

Section: Discussionsupporting

confidence: 90%

“…Recent retrospective studies comparing vaginal progesterone and intramuscular P for replacement in cryopreserved embryo transfer cycles have yielded conflicting results (25)(26)(27)(28). One retrospective analysis of 194 cryopreserved embryo transfer cycles reported a higher live birth rate when P was injected intramuscularly once every 3 days in addition to daily vaginal P administration (P¼ .0015 vs. vaginal P alone) (29).…”

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confidence: 99%

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Vitrified blastocyst transfer cycles with the use of only vaginal progesterone replacement with Endometrin have inferior ongoing pregnancy rates: results from the planned interim analysis of a three-arm randomized controlled noninferiority trial

Devine

Richter

Widra

et al. 2018

Fertility and Sterility

117

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Section: Discussionsupporting

confidence: 90%

mentioning

confidence: 99%

Vitrified blastocyst transfer cycles with the use of only vaginal progesterone replacement with Endometrin have inferior ongoing pregnancy rates: results from the planned interim analysis of a three-arm randomized controlled noninferiority trial

Devine

Richter

Widra

et al. 2018

Fertility and Sterility

117

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“…In addition, FET provides a good model for evaluating the efficacy of progesterone replacement, since recipients of frozen embryos have no functioning corpora lutea and therefore produce no endogenous progesterone. Several studies have suggested lesser quality embryos may be transferred in FET cycles, especially with embryos derived from autologous oocytes, and that more intense progesterone support may be required in these cycles (Kaser et al , 2012; Feinberg et al 2013). Our study showed that even in FET cycles derived from autologous oocytes, vaginal progesterone gel and IMP resulted in similar clinical pregnancy rates (IMP versus Crinone; 62.4 versus 64.9%, P = 0.60) and live birth rates (IMP versus Crinone; 49.6 versus 53.4%, P = 0.42).…”

Section: Discussionmentioning

confidence: 99%

Progesterone replacement with vaginal gel versus i.m. injection: cycle and pregnancy outcomes in IVF patients receiving vitrified blastocysts

et al. 2014

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STUDY QUESTIONDoes the type of luteal support affect pregnancy outcomes in recipients of vitrified blastocysts?SUMMARY ANSWERLuteal support with vaginal progesterone gel or i.m. progesterone (IMP) results in comparable implantation and pregnancy rates in IVF patients receiving vitrified blastocysts.WHAT IS KNOWN ALREADYIn fresh IVF cycles, both IMP and vaginal progesterone have become the standard of care for luteal phase support. Due to conflicting data in replacement cycles, IMP is often considered to be the standard of care.STUDY DESIGN, SIZE, DURATIONRetrospective analysis of 920 frozen embryo transfer (FET) cycles between 1 January 2010 and 1 September 2012.PARTICIPANTS/MATERIALS, SETTING, METHODSPatients from a large, private practice undergoing autologous and donor FET using IMP or vaginal progesterone gel for luteal support were included in the analysis. IMP was used for luteal support in 682 FET cycles and vaginal progesterone gel was used in 238 FET cycles. Standard clinical outcomes of positive serum hCG levels, implantation, clinical pregnancy, spontaneous abortion and live birth were reported.MAIN RESULTS AND THE ROLE OF CHANCEThe IMP and vaginal progesterone gel groups had similar patient demographics for all characteristics assessed. Implantation rates (46.4 versus 45.6%, P = 0.81), clinical pregnancy rates (61.7 versus 60.5%, P = 0.80) and live birth rates (49.1 versus 48.9%, P > 0.99) were not significantly different between IMP and vaginal progesterone gel, respectively.LIMITATIONS, REASONS FOR CAUTIONThis study is limited by its retrospective design and by its lack of randomization to the type of luteal support. In addition, because no a priori expected rates of success could be provided for this retrospective investigation, it was not possible to estimate statistical power associated with the various outcomes presented.WIDER IMPLICATIONS OF THE FINDINGSWith the recent trends toward single embryo transfer (SET) and use of vitrified blastocysts in FET cycles, our data with ∼40% of cycles being SET and use of exclusively vitrified blastocysts are more relevant to current practices than previous studies.STUDY FUNDING/COMPETING INTEREST(S)Support for data collection and analysis was provided by Actavis, Inc. D.S. has received honoraria for lectures and participation in Scientific Advisory Boards for Actavis, Inc. J.P. is an employee of Actavis, Inc. N.E. has received payment from Actavis, Inc., for her time for data collection. H.H. has received payment from Actavis, Inc., for statistical analyses. Z.P.N. has nothing to disclose.

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“…However, a recent study reported that in frozen embryo transfer (FET) cycles, clinical pregnancy and live birth rates were significantly improved by the additional use of i.m. progesterone …”

Section: Introductionmentioning

confidence: 99%

Effectiveness of high‐dose transvaginal progesterone supplementation for women who are undergoing a frozen‐thawed embryo transfer

Enatsu

Kishi

et al. 2018

Reprod Medicine & Biology

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PurposeTo evaluate the effectiveness of high‐dose progesterone supplementation for women who are undergoing a frozen‐thawed embryo transfer (FET).MethodsAmong the 2010 FET cycles that were included in the present study, 1188 were 1200 mg/d of vaginal progesterone, while 822 were 900 mg/d. The dose of progesterone that was used was decided by the treatment period and additional progesterone supplementation was used when the serum progesterone levels were <9 ng/mL on luteal day 5.ResultsThe clinical pregnancy rate was higher in the 1200 mg group than in the 900 mg group. The mean serum progesterone level on luteal day 5 in the 1200 mg and 900 mg groups was 12.6 ng/mL and 13.4 ng/mL, respectively. The rate of additional progesterone supplementation was higher in the 1200 mg group. A logistic regression analysis identified a younger age (≤37 years) and the use of 1200 mg progesterone as independent predictive factors for the clinical pregnancy outcome. The analysis of the infant outcomes revealed no significant difference in the distribution of birth ages and weights.ConclusionHigh‐dose transvaginal progesterone of 1200 mg/d as luteal support contributed to good pregnancy outcomes.

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Endometrin as luteal phase support in assisted reproduction

Cited by 24 publications

References 16 publications

Vitrified blastocyst transfer cycles with the use of only vaginal progesterone replacement with Endometrin have inferior ongoing pregnancy rates: results from the planned interim analysis of a three-arm randomized controlled noninferiority trial

Vitrified blastocyst transfer cycles with the use of only vaginal progesterone replacement with Endometrin have inferior ongoing pregnancy rates: results from the planned interim analysis of a three-arm randomized controlled noninferiority trial

Progesterone replacement with vaginal gel versus i.m. injection: cycle and pregnancy outcomes in IVF patients receiving vitrified blastocysts

Effectiveness of high‐dose transvaginal progesterone supplementation for women who are undergoing a frozen‐thawed embryo transfer

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